Gupta Ruchi S, Zhang Xingyou, Sharp Lisa K, Shannon John J, Weiss Kevin B
Institute for Healthcare Studies, Northwestern University Feinberg School of Medicine, Chicago, IL 60614, USA.
J Allergy Clin Immunol. 2008 Mar;121(3):639-645.e1. doi: 10.1016/j.jaci.2007.11.036. Epub 2008 Feb 4.
Childhood asthma prevalence has been shown to be higher in urban communities overall without an understanding of differences by neighborhood.
To characterize the geographic variability of childhood asthma prevalence among neighborhoods in Chicago.
Asthma screening was conducted among children attending 105 Chicago schools as part of the Chicago Initiative to Raise Asthma Health Equity. Additional child information included age, sex, race/ethnicity, and household members with asthma. Surveys were geocoded and linked with neighborhoods. Neighborhood information on race, education, and income was based on 2000 census data. Bivariate and multilevel analyses were performed.
Of the 48,917 surveys, 41,255 (84.3%) were geocoded into 287 neighborhoods. Asthma prevalence among all children was 12.9%. Asthma rates varied among neighborhoods from 0% to 44% (interquartile range, 8% to 24%). Asthma prevalence (mean, SD, range) in predominantly black neighborhoods (19.9, +/-7, 4% to 44%) was higher than in predominantly white neighborhoods (11.4, +/-4.7, 2% to 30%) and predominantly Hispanic neighborhoods (12.1, +/-6.8, 0% to 29%). Although sex, age, household members with asthma, and neighborhood income significantly affected asthma prevalence, they did not explain the differences seen between neighborhoods. Race explained a significant proportion (about 80%) but not all of this variation.
Childhood asthma prevalence varies widely by neighborhood within this urban environment. Adjacent areas in Chicago were identified with significantly different asthma prevalence. A better understanding of the effect of neighborhood characteristics may lend insight into potential interventions to reduce childhood asthma.
总体而言，城市社区儿童哮喘患病率较高，但尚不清楚不同社区之间的差异情况。
描述芝加哥各社区儿童哮喘患病率的地理变异性。
作为芝加哥提高哮喘健康公平性倡议的一部分，对就读于芝加哥105所学校的儿童进行了哮喘筛查。其他儿童信息包括年龄、性别、种族/民族以及患有哮喘的家庭成员。调查进行了地理编码并与社区相关联。关于种族、教育和收入的社区信息基于2000年人口普查数据。进行了双变量和多水平分析。
在48917份调查问卷中，41255份（84.3%）被地理编码到287个社区。所有儿童的哮喘患病率为12.9%。各社区的哮喘患病率从0%到44%不等（四分位间距为8%至24%）。以黑人为主的社区哮喘患病率（均值、标准差、范围）为（19.9，±7，4%至44%），高于以白人为主的社区（11.4，±4.7，2%至30%）和以西班牙裔为主的社区（12.1，±6.8，0%至29%）。虽然性别、年龄、患有哮喘的家庭成员以及社区收入显著影响哮喘患病率，但它们并不能解释各社区之间的差异。种族解释了很大一部分（约8０%）但并非全部这种差异。
在这个城市环境中，儿童哮喘患病率因社区而异。芝加哥相邻地区的哮喘患病率存在显著差异。更好地了解社区特征的影响可能有助于深入了解减少儿童哮喘的潜在干预措施。
